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H B Taussig

Publications and source records attributed to H B Taussig.

At least 19 recordsLinked to original sources

Evolutionary origin of cardiac malformations.

The author has proposed in previous publications that isolated cardiac malformations have an evolutionary origin. This is partly supported by the fact that isolated cardiac malformations found in humans occur also in other placental mammals as well as in birds. External gross examination of the heart in just over 5,000 birds was carried out during a 3 year period. Anomalies included one instance of duplicate hearts, two specimens in which no heart could be identified and in a fourth, a yellow-rumped warbler, the heart lay in the neck outside of the thoracic cavity. Published reports of similar occurrences of an ectopically placed heart concern birds, cattle and humans. The fact that various species of both placental mammals and birds show evidence of heritability for heart defects, and that these species cannot interbreed, combined with the fact that birds and mammals have many similar malformations, points to either a common external causative factor or a common origin. Genes that code the malformed heart must be transmitted with that part of the genetic makeup common to all birds and mammals. Malformations caused by teratogens produce widespread organ injury to a potentially normal embryo whereas the evolutionary malformation is an organ-specific anomaly in an otherwise normal mammal or bird and occurs in widely separated species. The implications of this theory are important for parents of children with an isolated congenital heart defect who may have ingested one or another drug or chemical or have been exposed to toxins or infectious agents before or after conception of the affected offspring.

Animals↗

World survey of the common cardiac malformations: developmental error or genetic variant?

The common cardiac malformations are prevalent throughout the world, in countries of high technology and among the primitive races. These same malformations were described 200 years ago, ectopia cordis 5,000 years ago. Their recent increase is directly related to the advent of cardiac treatment. Most cardiac malformations known to man occur in the dog. The prevalence rate of these malformations is the same in the dog and in man (5-8/1,000). Several of the malformations are heritable in specific breeds of dogs, one in rabbits, another in rats. These malformations occur in various animals that cannot interbreed. Hence the deoxyribonucleic acid (DNA) that codes these malformations must lie in that portion of the DNA common to all mammals. This suggests that these malformations occurred during the evolution of the Mammalia. Mammals evolved from reptiles, animals with hearts of various structures for the separation of arterial and venous blood. Although the "normal" heart is the most compatible with mammalian life and hence the most common, some mammals may have evolved with a heart with different structures for the separation of arterial and venous blood. Some of these hearts have persisted. These primeval hearts we call cardiac malformations of the cyanotic group. Malformations that apparently are arrests in the development of the normal heart (patent ductus arteriosus, atrioventricular canal) may represent stages in the evolution of the "normal" heart. Although teratogens and mutagens do exist, the author conceives of congenital cardiac malformations not as arrests or errors in the development of a "normal" heart but as genetic variants.

Adult↗

Long-time observations on the Blalock-Taussig operation IX. Single ventricle (with apex to the left).

This report concerns a 20 to 28 year follow-up of patients with a single ventricle with pulmonary stenosis and levocardia, a malformation which is frequently combined with a transposition of the great vessels. Only 24 cases were found among the 1037 cyanotic patients with decreased pulmonary blood flow operated on between January 1, 1945 and January 1, 1951. Of the 18 patients who survived surgery, one has been lost to follow-up, eight have lived for more than 20 years, and six for more than 25 years after their initial operation. The results of a Blalock-Taussig operation for a single ventricle are less satisfactory than for a tetralogy of Fallot. Two patients who were living at the close of the study have had no further surgery. Seven patients have had a second operation and four patients have had a third. Progressive cardiac enlargement has been common. The period of enlargement has varied from 10 months to more than 20 years. Three patients have had subacute bacterial endocarditis; two had multiple attacks. One patient died of a brain abscess and one of a purulent meningitis. Three women and four men have married. All four men have A.B. degrees and are gainfully employed.

Adolescent↗

Long-time observations on the Blalock-Taussig operation VIII. 20 to 28 year follow-up on patients with a tetralogy of Fallot.

This study extends our previous observation on patients with a tetralogy of Fallot, operated on by the late Dr; Alfred Blalock and his associates between 1945 and 1951, from a 15 year follow-up to 20 years and assesses the final status of these patients 20 to 28 years after their first operation. This study is mainly concerned with the 432 patients known to be alive at the beginning of the 15th postoperative year. At the beginning of the 20th year, 376 patients were alive, 24 had died, 32 had been lost to follow-up. Review of the final status of those 432 patients showed that 169 had no further cardiac surgery after their initial operation, 36 had further palliative surgery, and 227 had total correction. Thirty-seven percent of the first group, and 79.3% of those with total correction were doing well. These two groups, however, are not comparable. Approximately 250 patients have married; 161 have one or more children. Thirty-five percent have graduated from college and 68.7% are earning substantial incomes. The high scholastic achievement of many of these patients is strong evidence that low oxygen saturation of arterial blood is not a prime cause of mental retardation. The occupations of the patients indicate that the quality of their lives is extremely good and that a cardiac handicap in childhood does not preclude success in adult life. Approximately 69% of these patients have repaid in taxes the cost to society of their rehabilitation.

Educational Status↗